Malignant neoplasm of the uterine neck among all female oncology occupies 15% of cases, and in the prevalence goes to third place after breast cancer and the body of the uterus.
Unfortunately, at the initial stages, malignant neoplasm of cervical tissues is detected only in 15% of patients, about 40% of patients learn of pathology at stages 3 or 4, when the oncoprocess is incurable.
Is the disease treated?
Cervical cancer at first does not give itself out and develops slowly, and therefore it is almost impossible to detect it in this phase.
But if the cervical cancer was still detected at the initial stage, then in 96% of cases, oncology can be completely cured.
Oncologists assure that cervical cancer today is quite successfully treated, however, oncology should be detected at the beginning of development, and treatment is started in a timely manner.
Only when these conditions are met, does the patient have all the chances of recovery.
Recovery is provided by an organ-preserving surgical intervention, after which there will be no trace of cancer, and the mother's motherhood will remain.
In clinical trials, there is no hope for a favorable outcome of therapy. The operation is extensive, including removal of the uterus, appendages and other affected tissues, so the patient is deprived of fertility.
Types of cervical cancer treatment
The nature of the therapeutic approach depends on several leading factors, such as the oncology process and its stage, the presence of metastasis, etc.
- The basis of treatment is surgical intervention.
- Radiotherapy is also widely used in the treatment of cervical cancer, sometimes the course of irradiation is performed before and after surgery.
- Chemotherapeutic effects usually have an auxiliary value and often remain ineffective.
- In addition, in the treatment of malignant cervical oncology hormonal therapy based on the use of steroid drugs such as antiestrogens and progestogens can be used. Such treatment is justified for the hormone-dependent nature of the tumor, which is determined in the process of laboratory diagnosis.
Preventive vaccine for girls
Doctors believe that all girls and women of the 9-26-year-old age group should be vaccinated against uterine cervical cancer, especially vaccination is necessary for girls who have not yet started to live a sexual life.
In many European and Western countries, this vaccine is included in the register of mandatory vaccinations, however, for countries of the former CIS and Russia, this vaccination is available only on a fee basis.
In fact, the vaccine is not introduced from cancer, but against highly-oncogenic HPV types that cause a cervical malignant tumor. Two vaccines against cervical cancer are used:
- Cervarix of Belgian production, done according to a three-stage scheme 0-1-6 months;
- Gardasil of Netherlands made, scheme 0-2-6 months.
The injections are administered intramuscularly. After the introduction of the body, specific antibodies are synthesized, whose activity is directed to the elimination of HPV pathogens.
Cost of Inoculation
According to data for 2014-15, the price of one dose of Gardasil is about 5600-6200₽.
The Cervarix vaccine will cost around 5000-5400₽.That is, on average, a full course of vaccines for cervical cancer will cost 15,000-18600₽.
Immunity is formed after a year and a half after the introduction of the last phase of the vaccine.
When ingested, HPV is quickly recognized by cells and will be destroyed.
A similar immune response will help prevent the development of lesions of the cervical tissues.
Reviews about the vaccination from doctors and patients
The population has a dual opinion about these vaccines, which is not surprising. In the course of the research, there were cases when, after vaccination with Gardasil, very young 16-year-olds had a premature menopause when the ovaries stopped their activity.
Before the vaccination, these patients were completely healthy, with a regular and healthy cycle, however, during the 2-year period after the vaccination, they began intermittent with monthly, until menstruation did not stop.
It was found out at the examination that these girls killed absolutely all eggs, and the ovaries irretrievably atrophied, that is, they had no chances of motherhood. Of course, such cases are rare, but they have a place to be, so you can not close your eyes to them.
Even the gynecologists of a number of highly respected capital midwifery centers treat such a vaccine with disbelief. This is understandable, because of these drugs, almost nothing is known.
It is not enough practice to use it, there is not enough testing and research, and the time for observation of vaccinated patients is too short. In general, there are more questions regarding such vaccines than precise and specific data.
Side effects of
Among the consequences that arise in patients after vaccination against cervical cancer, specialists identify the following:
- Soreness at the injection site;
- Diarrhea;
- Headaches;
- Nausea and vomiting syndrome;
- Flatulence;
- Rashes, similar to hives;
- Vertigo;
- Skin itching;
- Arthralgia and myalgia;
- Muscle weakness;
- ENT pathology of infectious origin;
- Hyperthermia;
- Excessive fatigue.
Such vaccination is unacceptable with individual hypersensitivity to the suspension, allergic reactions to the previous stage of vaccination, fever, pregnancy.
Surgery
The main therapeutic method of cervical cancer oncology is surgery.
At the initial stages of the tumor process, organ-preserving surgeries are conducted, leaving a woman capable of procreation.
For more serious lesions, removal of the uterus and organs, to which the pathology has spread, is indicated.
Operation Wertheim
It is quite common in modern oncosurgical practice to use Wertheim's method for cervical cancer.
The woman is exposed to the abdominal wall, parametric fiber, regional lymph nodes, uterus, upper third of the vagina, appendages are removed alternately. Then the incisions are sewn. Sutures are removed after about a week and a half after surgery.
The patient experiences usually very hard first days after surgery. She is tormented by severe pain, while doctors recommend that a woman walk more to "disperse blood."
For about 10 days a woman will have a stomach ache. The patient is prescribed a gentle diet and the constant wearing of elastic stockings to prevent thrombophlebitis.
Complications of operation
Among the early postoperative complications can be identified:
- Urinary disorders;
- Inflammatory processes in the suture tissues;
- Internal or external bleeding;
- Thromboembolism of the arteries of the lung
- Hematomas;
- Peritonitis.
The main complication after Wertheim surgery is the absence of genital functions, because a woman can not become a mother without a uterus. In addition, there is a real threat of adhesive process between the intraorganic structures and the abdominal wall, which is observed in 90% of patients after the extirpation of the uterus.
Also, after removal of the uterine body and appendages, a premature menopause occurs, accompanied by hot flashes, a labile emotional state, brittle hair, nail plates, skin aging, incontinence, lack of libido and sexual arousal, etc.
Radiation therapy
Radiotherapy for cancer of the cervixis considered the most priority therapeutic direction, especially in the late stages of oncoprocess.
In the early stages of cancer, irradiation is performed in conjunction with surgical treatment.
The essence of radiotherapy is the effect of X-rays on cancer cells, leading to their destruction and cessation of further growth of malignant formation.
Irradiation can be performed in several ways:
- Intracavitary;
- External.
Intracavitary radiotherapy involves the introduction of a special radiating device( tube applicators) directly into the vagina and cervix, i.e., radiation exposure is carried out directly on the area affected by cancer.
Irradiation by external means involves the use of radiation through the abdominal wall. In this case, partial irradiation of healthy tissues occurs, which makes the procedure less preferable, in contrast to intracavitary radiation therapy.
Reviews
Among patients, there are mostly positive reviews about this method of treatment.
Irishka:
In the summer of that year, the uterus and ovaries were removed because of the launched cervical cancer. Found only in 3 stages. After all the "horrors" of irradiation and chemotherapy passed. Three months after the last radiation came to the examination - everything is fine, no cancer cells were found. In the winter, again underwent a check in the oncology center, now every 3 months. It is necessary to hand over analyzes. About cancer, and there is no trace, most importantly, to believe in a cure.
Mari:
I went to the third year after the diagnosis of cervical cancer. Many positive and negative trends in treatment. Gradually, complications of irradiation like cystitis begin to crawl out. While they were treating the cervix, they burned the rectum. No mood, deep depression, fatigue, weakness wild. There is no longer any desire to continue treatment.
Effects of irradiation
Among the most common effects of radiotherapy in cervical cancer, experts identify:
- Loss of ovarian activity leading to ovulation and infertility;
- Menopause;
- Bleeding from the vagina;
- Diarrhea;
- Constant weakness;
- Discomfort when urinating like burning;
- Narrowing of the vagina;
- Nausea and vomiting syndrome;
- Irritations of a local nature.
Chemotherapy
Chemotherapy for cervical malignant oncology is usually used in the late stages of the disease, when metastasis develops into the lymph nodes, and the probability of cure by other methods is minimal.
Antitumor drugs are taken orally or intravenously. The most commonly used medicines are like:
- Ifosfamide;
- 5-Fluorouracil;
- Cisplatin;
- Paclitaxel;
- Topotecan.
These antineoplastic agents are administered together or in the form of monotherapy.
Nutrition for chemotherapy for cervical cancer
To reduce the complications and adverse reactions of chemotherapy, women are advised to eat more vitamins in the form of fresh fruits and vegetables. It is necessary to enrich the diet with protein products - chicken, beef, seafood, nuts.
For breakfast it is better to eat cereals and bread so that the body gets the carbohydrates needed to fight against aggressive external factors. You also need to include in the menu and dairy products containing protein.
Complications of
Among the complications of chemotherapy specialists distinguish:
- Symptomatic vomiting;
- Anemia signs;
- Neutropenia;
- Inflammatory processes on the mucous tissues of the mouth;
- Bleeding tendency;
- Renal impairment;
- Refusing to eat;
- Alopecia;
- Numbness in the legs, hands;
- Dangerous reproductive harm.
Immunotherapy
The immunotherapeutic method of cervical cancer treatment refers to the medicamentous methods and involves the use of drugs that have the strongest antiviral effect.
When the body fights against the cancer process, there is a strong decrease in the immune status, so the patient needs additional immune support. To do this, immunotherapy is prescribed using interferon, which has the strongest protective and antitumor effect.
But such an approach to treatment is justified only at the initial stages of oncology and only under strict expert supervision of the oncologist.
Interferon preparations can be used as injections or ointments. Intracavitary injection of drugs into the cervical canal or local ointment compress often contributes to the reverse development of the tumor process, until complete recovery.
Gardasil from papilloma and cervical
The drug Gardasil consists of protein antigens of highly-oncogenic HPV types and is used to vaccinate girls against cervical cancer.
Externally, Gardasil is a white opaque suspension.
This vaccine is used for the prevention of:
- Dysplastic changes in the vagina, cervical canal, external genitalia and uterine necks cancer that result from highly oncogenic papillomaviruses;
- Genital genital warts having an etiological relationship with oncogenic types of papillomavirus.
After the completion of the course of taking the drug, the formation of specific antibodies to human papillomavirus begins.
Diet
A significant factor in the formation of the oncology process in the cervix is unhealthy nutrition, suggesting the use of carcinogenic products with various additives of artificial origin, fast food or semi-finished products.
The picture is worsened by a depressed state, a constant sense of fatigue, and obesity. Traditional medicine can help the patient cope with oncology, however, the oncology diet has an important role for the success of treatment.
You have to eat fish, lean meat, sour-milk products, cereals. Alcohol and chocolate, coffee and smoked products, fatty foods and canned goods, confectionery and overly sharp products are all under strict prohibition. Sugar and salt are used in strictly limited measures.
How cervical cancer is treated in different stages of
The approach to oncology treatment depends on its stage:
- Stage 0 - treatment is organ-preserving in nature and is performed by laser evaporation, scalpel excision of the affected cervical tissue, ultrasound removal of the cervical canal, or cryodestruction. If the patient is over the age of 50, Wertheim surgery is carried out, because such patients do not need reproductive functions;
- Stage 1 - is treated surgically. When choosing the type of surgery, genetic predisposition to oncology, gynecological anamnesis, planning of children, etc. are taken into account. Methods such as knife amputation, cone electroexcision, cryodestruction, ultrasound or laser removal of the cervix are usually used, however, the most reliable method of treating cancer is considered to be uterine extirpation;
- Stage 2 - methods like brachytherapy combined with external irradiation are applied, with large sizes of education( more than 4 cm), brachytherapy is supplemented with chemotherapeutic treatment. After radiotherapy, a hysterectomy is performed;
- Stage 3 - combined treatment with chemotherapy, intracavitary and external irradiation, detoxification and general restorative therapy;
- Stage 4 - mainly irradiation and use of antitumor drugs are used. Metastasis is widespread, so surgical treatment is meaningless. Therapy is conducted to maintain the patient and eliminate the intolerable pain syndrome, in other words, palliative therapy.
Relapse and its symptoms
If cancerous lesions of the cervix are detected at the initial stage and treatment is taken on time, then the therapy is very successful and leads to a stable remission, however, there are patients who, after treatment( in the first 3 years after therapy), relapse occurs.
There are about 30% such cancer patients.
Symptoms of relapse are due to the condition of the cervical canal. If radiation therapy has led to the infection of the cervical passage, then in the cavity there is accumulation of secretions.
Cavity increases, causes severe pain. The pains are localized mainly in the lumbar region, the lower abdomen and the sacrum. Especially intense soreness in the night.
If the permeability of the cervical canal is normal, then purulent, prenucous or watery discharge may occur. Often relapses of cervical cancer are manifested by edema of the legs, hyperthermia, dysuric symptoms. However, it happens that there are no clinical signs of such conditions, that is, the recurrence is asymptomatic.
Forecast and results of
The outcome of treatment and prognosis depends on a variety of factors, such as the extent of the lesion, the stage of its development, the type of cancer cells, etc.
- When treatment is detected and initiated in the first stage of oncology, the treatment is successful, and 80% survive for 5year term.
- In the second stage, the results of treatment are less favorable, and the survival rate is 45-50%.
- In the third stage, the outcome of treatment depends on the scale of the tumor process. The prognosis of survival at this stage is about 30%.
- In the fourth stage, cervical cancer is not cured, the therapy is mostly palliative. Survival is less than 10%.
Prevention
Preventive measures of cervical cancer are presented by primary and secondary techniques.
Secondary preventive measures of cervical cancer suggest early diagnosis of precancerous pathologies, for which cytological screening, Pap test and other diagnostic studies were created.
In addition, today there is a vaccine that prevents the infection with cancer-dangerous types of human papillomavirus. And the role of HPV in the occurrence of cervical cancer is for certain.
On the combined treatment of cervical cancer, will tell the following video:
Video about a cancerous cervical tumor in combination with pregnancy: